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Thursday, July 19, 2012

Final Injury Update-Extensor Tendonitis

*Here is a link to my first Injury Update, which explains more about the injury itself, and is the basis for which I formulated this post.

It's been a little over 2 months since I began feeling pain
in my foot from switching to barefoot running.
I am no longer running barefoot, but I am running quite well with a pair
of minimalist shoes (Saucony Kinvara 3).
I've logged around 100 miles over the past 5 weeks in these shoes and my
foot is feeling completely better. I
figure that since my injury is completely behind me...knock on wood...I should
post an update to the treatments I used.

Ice: This continued
to be a lifesaver for me. I continued to
ice my foot, as described in my previous post, throughout my healing process. I also began a routine of applying heat,
friction massage, then ice which I'll describe later.

Compression: I
continued to wear an elastic bandage throughout the day, especially if I knew I
would be walking a lot. This helped for
the first few weeks, but around week 3-4 it started to feel like it made things
worse. I discontinued wearing the wrap
after that. I think the discomfort was
caused by the added pressure from the wrap on the top of my foot where the
inflamed tendons travel along my foot.
Initially it provided comfort, perhaps by adding stability and
cushioning to my fore-foot.

Wear Running Shoes: I
continued to do this throughout the entire recovery process. I started out with my old Mizuno Wave Rider shoes (This link will take you to the current model, but mine are 12's). The WR's had been through a marathon and much
more, so they were pretty shot. I
switched to a pair of Kinvara 3's about 3 weeks post injury. My Kinvara 3's felt better than any other
pair of shoes I own so I wore them everywhere until about 7 weeks after
injuring myself.

Forefoot Padding: I
actually quit using this after about 3 weeks or so. After switching to wearing the K-3's all of
the time, there was no need for additional padding. The extra padding did seem to help initially
though, so it may be worth trying. As a
side note, I read several internet posts about people placing cotton balls
between their toes to relieve stress from inflamed tendons in their foot;
however, this didn't seem to provide any relief from discomfort for me.

Stretching:
Stretching continued to be a great help for me, especially calf
stretching. Once my foot was feeling a
bit better (about 3-4 weeks post injury) I started doing a stretch on the top
of my foot where I would sit in a chair, place the ankle of my injured foot on
my opposite thigh, and use my hand to gently bend my toes downward. I would have to apply counter pressure with
my thumb on the bottom of my foot near my arch.
I would recommend any leg stretches that don't seem to aggravate the
injury while doing them.

Friction Massage: I
stumbled across friction massage several weeks into my recovery and this seemed
to help tremendously. It's not entirely
comfortable, but it really helped to pinpoint the injured area and also seemed
to alleviate pain for hours afterwards.
Here is how to perform friction massage.
I highly recommend this!

Toe Raises: I
actually quit doing these shortly after my original post. I quickly decided that strengthening
exercises weren't helpful early on in recovery.
I would recommend these for injury prevention, but not for treatment.

Running: I definitely
don't recommend running while injured. I
went on a few light runs, but decided that it was actually making the problem
worse. I could feel pain in my foot
while running, but since it wasn't severe I thought I could just run through
it. I did; however, find that after
about 2-3 weeks of rest I could walk/hike relatively pain-free. I started walking as much as my foot would
allow. I tried to just listen to my
body. If my foot started getting sore, I
toned down the walking. If I felt good I
kept going. I actually did several 5-10
mile hikes with my 1-year-old son in our Baby Carrier Backpack. This may not work for you if you're injured,
but I think it really helped me recover.
I think that stimulating the tendons, without causing pain, is very beneficial
to recovery.

Rest: I ended up
taking another 2 weeks off from running completely, with the exception of a few
light "test" runs, for a total of 4 weeks off. In order to keep my sanity I started walking
and hiking quite a bit to at least stay somewhat active.

Now that I've revisited all of the previous treatment
methods I mentioned before, I'd like to mention the heat, friction massage, ice routine
that, in my opinion, was more helpful than anything else. First thing in the morning I would apply a
heat pad by wrapping it around my foot and securing it in place with the
elastic bandage I used use to wrap my foot.
I would leave the heat on for about 20 minutes, making sure that the
heat was concentrated on the top of my foot between my toes and ankle. Next I would conduct a friction massage for
about 10 minutes as described in the link.
During the massage I would start rubbing very gently and as time went on
I was able to increase the pressure. By
the end of each massage my thumbs would be very tired from applying so much
pressure. By the end of the massage I
could feel the pain centralize to a very specific point on the tendon, maybe
the size of my fingertip. After the
massage I would apply ice for 20 minutes.
This felt SO good, as the massage isn't exactly pleasant. By the time I finished this ~50 minute
process my foot felt absolutely wonderful, and it only got better the more that
I did it. Occasionally I would end up
applying ice again later in the day if my foot was really bothering me.